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Urinary tract infections in newborns

Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

Urinary tract infections can result from bacteria such as E. coli, or less often from a congenital anomaly that obstructs urine flow. The signs are usually those of an early non-specific infection. Diagnosis is usually confirmed through laboratory evaluation of a urine sample.

Renal/Genitourinary system

Urinary infections typically present with lethargy, poor feeding, increasing jaundice and vomiting. Urine that only dribbles out, rather than being passed forcefully, may be an indication of a problem with posterior urethral valves. Urine that is cloudy in appearance or smelly may be an indication of a urinary tract infection.

Renal problems may present as a failure to pass urine. The normal infant usually passes urine 4-10 hours after birth. Normal urine output for a term baby in the first day of life should be 2-4 ml/kg/hour. Urine output of less than 1 ml/kg/hour (oliguria) should be investigated.

Common causes of reduced urine output include:

  • Inadequate fluid intake
  • Increased fluid loss due to hyperthermia, use of radiant heaters and phototherapy units
  • Birth asphyxia
  • Congenital abnormalities
  • Infection.
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